Language Skills of Children with Early Cochlear Implantation.

[Cloggy]

Interesting research / article....

Language Skills of Children with Early Cochlear Implantation.

Article

Ear & Hearing. 24(1) Supplement:46S-58S, February 2003.
Geers, Ann E.; Nicholas, Johanna G.; Sedey, Allison L.
Abstract:
Objective: This study investigated factors contributing to the comprehension and production of English language by children with prelingual deafness after 4 to 7 yr of multichannel cochlear implant use. The analysis controlled for the effects of child and family characteristics so that educational factors most conducive to maximum implant benefit could be identified.

Design: A battery of language tests were administered to 181 8- and 9 - yr-old children from across the United States and Canada who received a cochlear implant by age 5. Tests of comprehension, verbal reasoning, narrative ability and spontaneous language production were administered either in speech and sign or in the child's preferred communication mode. These constituted the Total Language measures. Spoken Language measures were derived from a speech-only language sample. Type and amount of educational intervention since implantation constituted the independent variables. Characteristics of the child and the family were considered intervening variables. A series of multiple regression analyses determined the amount of variance in Total Language and Spoken Language ability accounted for by the intervening variables and the amount of additional variance attributable to the independent variables.

Results: More than half of the children (with performance intelligence quotients in the average range) exhibited language skills that were similar to those of hearing 8 to 9 yr olds on measures of verbal reasoning, narrative ability, utterance length, and lexical diversity. Significant predictors of language ability were similar for Total and for Spoken Language outcomes and included greater nonverbal intelligence, smaller family size, higher socio-economic status and female gender. Age at receiving an implant did not affect language outcome. After the variance due to these variables was controlled, the primary rehabilitative factors associated with linguistic outcome were amount of mainstream class placement and an educational emphasis on speech and auditory skills.

Conclusions: Use of a cochlear implant has had a dramatic impact on the linguistic competence of profoundly hearing-impaired children. More than half of the children in this sample with average learning ability produced and understood English language at a level comparable with that of their hearing age mates. Such mature language outcomes were not typical of children with profound hearing loss who used hearing aids. Use of a visual (i.e., sign) language system did not provide the linguistic advantage that had been anticipated. Children educated without use of sign exhibited a significant advantage in their use of narratives, the breadth of their vocabulary, in their use of bound morphemes, in the length of their utterances and in the complexity of the syntax used in their spontaneous language. An oral educational focus provided a significant advantage for both spoken and total language skills.
(C) 2003 Lippincott Williams & Wilkins, Inc.

More food for thought

 

[jillio]

Interesting research / article....



More food for thought

Yes, it is food for thought. However, I would refer you back tot he Marshark article that I posted that is more recent that found that the children that were highest performing cademically were those who had been exposed to sign and speech in an academic environment. And these chidlren were all CI users as well.

I wil access the entire article for which you have posted the abstract, as the abstract does not provide enough information to allow for evaluation.

 

[jillio]

Ah, this is one of the articles that was used in the lit review that I referenced by Marshark, et. al. If you will read Marshark's article all the way through, you will see how this study has been refuted by numerous others, when methodolgy was corrected and xtraneous variables controlled for. Also, please see the sponsoring body for the grant funding o this research.

 

[Cloggy]

Ah, this is one of the articles that was used in the lit review that I referenced by Marshark, et. al. If you will read Marshark's article all the way through, you will see how this study has been refuted by numerous others, when methodolgy was corrected and xtraneous variables controlled for. Also, please see the sponsoring body for the grant funding o this research.

Yeh, yeh, yeh.... just show me and other readers..

 

[rick48]

You often quote Marschark as someone to justify your views. However, in an interview in handsandvoices.org Marschark makes some pretty bold statements and while I may not agree with everything he says, he at least demonstrates an ability to have an open-mind on an issue that is clearly not black and white. I would ask others to go and read the entire interview, its pretty interesting and informative.

Seaver: So what do we really know about the kids who are reading at grade level compared to those above or below?

Marschark: ... I know it's possible for deaf children to read on grade level -- I know it's realistic! What makes the kids at or above grade level different from those, let's say, below grade level? The answer to that will make some people crabby. First, in contrast to the mantra that we often hear, there is no evidence that deaf children of deaf parents read significantly better than deaf children of hearing parents simply because of that parental hearing status. Deaf children who are exposed to both sign language early and spoken language (and/or print) read better than deaf children who are exposed to only one or the other. The key is early language--not early sign language, or early spoken language, or parents who are deaf or parents who can stand on their heads. It's early effective access to language.

The Parent Factor
Marschark: I know of only one study that tried to isolate what's different about the "good readers" from everybody else. It was a study done here at NTID a few years ago. Although it was only a preliminary study, my own observations and the data available convinced me that it is 100% correct. What they did was to take the top 10-20 deaf readers/writers on campus, interview them, throw test batteries at them, and try to answer essentially your question. There were three key variables that distinguished the good reader/writers from everybody else: #1 Parents, #2 Parents, and #3 Parents...the point is that parents who are most involved in their children's early education--both formally and informally--are likely to have the children who have the best outcomes...

Seaver: So it's boiling down to parents doing the right thing for their deaf child based on misunderstood research and a host of complex, unknown factors. Welcome to my world!

Marschark : ...A lot of the data out there are 100% clear, but many people are not willing to accept it. From deaf parents not really having children who read better, to sign language not really interfering with spoken language for children with implants, the facts make a lot of people very nervous.

Seaver: If you became the parent of a deaf child, what would you do?

Marschark: Interestingly, my view on that has changed quite a bit since 1997 when I wrote the first edition of Raising and Educating a Deaf Child...Since the second half of 2000, however, a wealth of evidence has clearly shown that most deaf children will benefit from cochlear implants, even if many of them will not benefit specifically with regard to spoken language (hearing environmental sounds can have important cognitive and social implications that should not be dismissed). So, now that I've seen the evidence, I would seriously consider a cochlear implant for my child, even if, at the same time, I would push for the acquisition of ASL as a first language and use some English-based signing as a bridge to English print. At the same time, I used to be a radical advocate of mainstream education for young deaf children. Having done the research that I have over the past 12 years since I came to NTID, my view on that has changed as well.

Solutions

Marschark : The evidence has convinced me, more than ever, that there is never going to be a "one size fits all" solution for deaf children either educationally or in language...It all starts with parents, and Hands & Voices seems to advocate the kind of flexibility that deaf children (and their families) really need while being willing to tell parents that it really is complicated... that there are not very many simple answers...I have learned a lot in the last 10 years.

 

[jillio]

Yeh, yeh, yeh.... just show me and other readers..

Already did. Just a question here: do you understand what an abstract is, and what the purpose of an abstract is?

 

[jillio]

You often quote Marschark as someone to justify your views. However, in an interview in handsandvoices.org Marschark makes some pretty bold statements and while I may not agree with everything he says, he at least demonstrates an ability to have an open-mind on an issue that is clearly not black and white. I would ask others to go and read the entire interview, its pretty interesting and informative.

Seaver: So what do we really know about the kids who are reading at grade level compared to those above or below?

Marschark: ... I know it's possible for deaf children to read on grade level -- I know it's realistic! What makes the kids at or above grade level different from those, let's say, below grade level? The answer to that will make some people crabby. First, in contrast to the mantra that we often hear, there is no evidence that deaf children of deaf parents read significantly better than deaf children of hearing parents simply because of that parental hearing status. Deaf children who are exposed to both sign language early and spoken language (and/or print) read better than deaf children who are exposed to only one or the other. The key is early language--not early sign language, or early spoken language, or parents who are deaf or parents who can stand on their heads. It's early effective access to language. The Parent Factor
Marschark: I know of only one study that tried to isolate what's different about the "good readers" from everybody else. It was a study done here at NTID a few years ago. Although it was only a preliminary study, my own observations and the data available convinced me that it is 100% correct. What they did was to take the top 10-20 deaf readers/writers on campus, interview them, throw test batteries at them, and try to answer essentially your question. There were three key variables that distinguished the good reader/writers from everybody else: #1 Parents, #2 Parents, and #3 Parents...the point is that parents who are most involved in their children's early education--both formally and informally--are likely to have the children who have the best outcomes... Seaver: So it's boiling down to parents doing the right thing for their deaf child based on misunderstood research and a host of complex, unknown factors. Welcome to my world!

Marschark : ...A lot of the data out there are 100% clear, but many people are not willing to accept it. From deaf parents not really having children who read better, to sign language not really interfering with spoken language for children with implants, the facts make a lot of people very nervous.

Seaver: If you became the parent of a deaf child, what would you do?

Marschark: Interestingly, my view on that has changed quite a bit since 1997 when I wrote the first edition of Raising and Educating a Deaf Child...Since the second half of 2000, however, a wealth of evidence has clearly shown that most deaf children will benefit from cochlear implants, even if many of them will not benefit specifically with regard to spoken language (hearing environmental sounds can have important cognitive and social implications that should not be dismissed). So, now that I've seen the evidence, I would seriously consider a cochlear implant for my child, even if, at the same time, I would push for the acquisition of ASL as a first language and use some English-based signing as a bridge to English print. At the same time, I used to be a radical advocate of mainstream education for young deaf children. Having done the research that I have over the past 12 years since I came to NTID, my view on that has changed as well.
Solutions

Marschark : The evidence has convinced me, more than ever, that there is never going to be a "one size fits all" solution for deaf children either educationally or in language...It all starts with parents, and Hands & Voices seems to advocate the kind of flexibility that deaf children (and their families) really need while being willing to tell parents that it really is complicated... that there are not very many simple answers...I have learned a lot in the last 10 years.

Gee rick, thanks for supporting what shel and I have been saying all along with the interview.

 

[Cloggy]

Already did. Just a question here: do you understand what an abstract is, and what the purpose of an abstract is?

YEP

 

[jillio]

YEP

Good, then you understand that it is useless in supporting arguments. Kindof like reading the dust jacket on a book, and believing that you have actually read the entire volume.

 

[Cloggy]

Good, then you understand that it is useless in supporting arguments. Kindof like reading the dust jacket on a book, and believing that you have actually read the entire volume.

Who is using as supporting argument... not me...
You can assume all you want, and perhaps that's how you see every abstract.... for me it is SHARING (there it is again ) with other members an article that could be interesting for someone...

BTW.. how many books have you read that had a conclusion on the dust-jacket.....
WOW... none??? so the comparison is not really valid....
That's OK..... I know what you mean...

Thanks for SHARING...... wasn't too bad - was it.?

 

[rick48]

Gee rick, thanks for supporting what shel and I have been saying all along with the interview.

And he also supports what I and others have been saying all along as well.

That was exactly my point, and you took the bait hook, line and sinker.

As we have said, its a complicated issue with no one solution and in the end, each child is different and their needs must be met accordingly.

"Marschark : The evidence has convinced me, more than ever, that there is never going to be a "one size fits all" solution for deaf children either educationally or in language...It all starts with parents, and Hands & Voices seems to advocate the kind of flexibility that deaf children (and their families) really need while being willing to tell parents that it really is complicated... that there are not very many simple answers...I have learned a lot in the last 10 years."

What worked for your child is what was best for him and we are happy for him, what works for my child and others is something different but that bothers you. It is too bad that you are too close-minded to appreciate that, take something from it and give it back to those students you claim to be "servicing".

I think Jackie summed it best, that you are exactly the type of person from the Deaf community that I did not want around my kids.

 

[jillio]

Who is using as supporting argument... not me...
You can assume all you want, and perhaps that's how you see every abstract.... for me it is SHARING (there it is again ) with other members an article that could be interesting for someone...

BTW.. how many books have you read that had a conclusion on the dust-jacket.....
WOW... none??? so the comparison is not really valid....
That's OK..... I know what you mean...

Thanks for SHARING...... wasn't too bad - was it.?

An abstract is incomplete information. It is intended the same as a dust jacket review.

 

[jillio]

And he also supports what I and others have been saying all along as well.

That was exactly my point, and you took the bait hook, line and sinker.

As we have said, its a complicated issue with no one solution and in the end, each child is different and their needs must be met accordingly.

"Marschark : The evidence has convinced me, more than ever, that there is never going to be a "one size fits all" solution for deaf children either educationally or in language...It all starts with parents, and Hands & Voices seems to advocate the kind of flexibility that deaf children (and their families) really need while being willing to tell parents that it really is complicated... that there are not very many simple answers...I have learned a lot in the last 10 years."

And he also said, as in the portion above that I bolded, that those who read best are exposed to BOTH sign and speech from an early age. THAT my friend, is what you seem to diagree with shel and myself regarding the education of deaf children. So while you may require flexibility in your decision to implant or not implant, to use HA or not use HA, to mainstream or send your child to a deaf school, one constant remains. Inall of these issues in which flexibility is accounted for, those who perform best are those that have been exposed to SIGN and SPEECH both as early as possible. Flexibility would include choosing to have your child implanted, or not. Flexibility would also include providing AVT for the nonimplanted child when appropriate, and exposing the CI implanted child to both sign and speech rathr than restricting them to one language. That is what Marshark is talking about, and if you have read and studied any of his numerous published research papers or the books he has written and co-authored, you would already understand this.

No one has ever said that parental involvement was not important, and a contributing factor to a child's success. What I have said, however, and backed it up with Marshark's research, that even when parental involvement was controlled for as a variable, the single most important variable that predicted academic success was exposure to both speech and sign. This held true for CI implanted children and non-CI implanted children. And this is the whole point that you continue to argue with me based on the fact that you are assumming that CI implanted children don't need sign and that it is not a benefit to them. The fact of the matter is, and you have just posted the research to support it, that deaf children, whether implanted with CI or not, perform at the highest level when they are exposed to both sign and speech from an early age.What worked for your child is what was best for him and we are happy for him, what works for my child and others is something different but that bothers you. It is too bad that you are too close-minded to appreciate that, take something from it and give it back to those students you claim to be "servicing".

I do give back to my students. I make sure that they have exposure to both languages. I did the same for my son. I am not closed minded at all, but quite obviously, you are, as you bring everything back to the debate of to implant or not implant. As Marshark has stated, that is where the flexibility lies, but if you implant, and you want your child to achieve, expose them to both languages. If you don't implant, and you want your child to achieve, expose them to both languages. It has nothing to do with implantation, rick. The issue is language exposure. In other words, the oral method is not the most approriate method for any child, implanted or not, unless you are comfortable reducing their opportunity to achieve.I think Jackie summed it best, that you are exactly the type of person from the Deaf community that I did not want around my kids.

I doubt seriously that you will ever have to worry about that, as you have no exposure to the Deaf community. And once your daughter is an adult, there is a better than average chance that she will marry another deaf individual and choose to affiliate with the deaf community on some level. That is no longer your choice for her. You can only restrict her for so long.

 

[Buffalo]

Interesting research / article....
Quote:
Language Skills of Children with Early Cochlear Implantation.

Children educated without use of sign exhibited a significant advantage in their use of narratives, the breadth of their vocabulary, in their use of bound morphemes, in the length of their utterances and in the complexity of the syntax used in their spontaneous language. An oral educational focus provided a significant advantage for both spoken and total language skills.
(C) 2003 Lippincott Williams & Wilkins, Inc.

More food for thought

Language Deprivation / Deaf Children
"A study of 140 families funded by the National Institutes of Child Health and Human Development showed that hearing children who were exposed to signing (in addition to speech) as babies have IQ scores averaging 12 points higher than the scores of the control group that didn't have additional language input. Increased language acquisition results in a measurable increase in intelligence."

Why do many of hearing people equate speaking with intelligence? Would it make sense to you if we equate sign language with intelligence?

Since increased language acquisition results in a measurable increase in intelligence, then where is the increased language acquisition for the deaf babies if they are denied sign language?

 

[jillio]

Language Deprivation / Deaf Children
"A study of 140 families funded by the National Institutes of Child Health and Human Development showed that hearing children who were exposed to signing (in addition to speech) as babies have IQ scores averaging 12 points higher than the scores of the control group that didn't have additional language input. Increased language acquisition results in a measurable increase in intelligence."

Why do many of hearing people equate speaking with intelligence? Would it make sense to you if we equate sign language with intelligence?

Since increased language acquisition results in a measurable increase in intelligence, then where is the increased language acquisition for the deaf babies if they are denied sign language?

Good question, Buffalo.

 

[R2D2]

Language Deprivation / Deaf Children
"A study of 140 families funded by the National Institutes of Child Health and Human Development showed that hearing children who were exposed to signing (in addition to speech) as babies have IQ scores averaging 12 points higher than the scores of the control group that didn't have additional language input. Increased language acquisition results in a measurable increase in intelligence."

While I feel positively about deaf babies having both sign and speech and would personally choose to start off this way if I had a deaf baby, I don't think we can interpret the above study as black and white as stating that exposure to sign language itself resulted in the increase in intelligence. I would say it was the strong commitment of the parents that results in such outcomes - i.e. parents of hearing children who bother to learn sign language are more committed parents compared to the general population, who often get the outcomes they strive for. The actual mechanics of how they do it is less important than this parental factor.

It's like what Maschark said in the article posted above the 3 factors influencing outcomes regardless of particular communication mode are parents, parents and parents.

 

[jillio]

While I feel positively about deaf babies having both sign and speech and would personally choose to start off this way if I had a deaf baby, I don't think we can interpret the above study as black and white as stating that exposure to sign language itself resulted in the increase in intelligence. I would say it was the strong commitment of the parents that results in such outcomes - i.e. parents of hearing children who bother to learn sign language are more committed parents compared to the general population, who often get the outcomes they strive for. The actual mechanics of how they do it is less important than this parental factor.

It's like what Maschark said in the article posted above the 3 factors influencing outcomes regardless of particular communication mode are parents, parents and parents.

And Marshark also said that when parental involvement was controlled for, speech plus sign achieved the better results.

I think that we can all agree that the parent who chooses to learn sign will be an involved parent. Likewise, the parent who commits to rigorous AVT without sign would most likely be a very involved parent. So, given that both are involved parents, what accounts for the difference in the bi-lingual kids?

 

[R2D2]

And Marshark also said that when parental involvement was controlled for, speech plus sign achieved the better results.

I think that we can all agree that the parent who chooses to learn sign will be an involved parent. Likewise, the parent who commits to rigorous AVT without sign would most likely be a very involved parent. So, given that both are involved parents, what accounts for the difference in the bi-lingual kids?

Early language, basically. This is what he said in the article:

The key is early language--not early sign language, or early spoken language, or parents who are deaf or parents who can stand on their heads. It's early effective access to language.

This is the reason why I'm personally in favour of a sign/speech strategy from the word go because it would allow me (theoretically if I ever had a deaf baby!) to get started on language right away, rather than waste time waiting in the CI process and then once activated, waiting for the child to get acustomed to hearing etc - which can take two-three years.

However, if there was another parent, just as committed, who had a child with a moderate loss, who had their child diagnosed with the newborn screening test and hearing aids were put onto the child within say 3 months of birth and the child benefited well from the aids, the advantage of adopting bi bi is not as great since language is being received early. Therefore an oral approach in this case is not going to result in language delays as much as a child who needed a CI but who didn't start to get language until the CI is up and running.

The fact that both you and Rick and see things in the article that you both agree on seems that you may be much closer in philosophy than you might think. (I hope I haven't said the wrong thing here!)

 

[jillio]

Early language, basically. This is what he said in the article:


Agreed, but I have read this whole article, and infact quoted it in another thread with numerous quotes. Inthe results and conclusions section of this particular paper, he states that across the board, the highest achievement scores were obtianed from children using both sign and speech.
This is the reason why I'm personally in favour of a sign/speech strategy from the word go because it would allow me (theoretically if I ever had a deaf baby!) to get started on language right away, rather than waste time waiting in the CI process and then once activated, waiting for the child to get acustomed to hearing etc - which can take two-three years.

completely agree.



However, if there was another parent, just as committed, who had a child with a moderate loss, who had their child diagnosed with the newborn screening test and hearing aids were put onto the child within say 3 months of birth and the child benefited well from the aids, the advantage of adopting bi bi is not as great since language is being received early. Therefore an oral approach in this case is not going to result in language delays as much as a child who needed a CI but who didn't start to get language until the CI is up and running.

The benefit might not be as great, but even aided with a moderate loss, there are gaps in waht the child hears. So while the benefit might not be as great, there will be some benefit.

The fact that both you and Rick and see things in the article that you both agree on seems that you may be much closer in philosophy than you might think. (I hope I haven't said the wrong thing here!)

LOL! I doubt that you will find him admitting that he agrees with me on anything!

 

[deafdyke]

the advantage of adopting bi bi is not as great since language is being received early.

Well yeah a kid with a more hoh loss, doesn't need Sign the way a deafer kid needs it, but on the other hand its still a VERY useful language to have. especially since hoh kids more often then not get lumped in and pushed towards the hearing world. Plus with Sign, a hoh kid can function both WITH and without their hearing aids. In today's world where hearing aids aren't generally covered by health insurance, its almost VITAL for a hoh kid to learn to function without their hearing aids.